Non-Melanoma Skin Cancers: The Basics
Non-melanoma skin cancer is caused by skin cells growing out of control. The two main types of non-melanoma skin cancer are:
- Basal cell.
- Squamous cell.
The other types are:
- Angiosarcoma.
- Cutaneous B and T cell lymphomas.
- Dermatofibrosarcoma protuberans.
- Merkel cell carcinoma.
- Sebaceous gland carcinoma.
- Kaposi's sarcoma.
This article will focus on basal and squamous cell.
Risks
Exposure to ultraviolet rays from the sun is the leading cause of non-melanoma skin cancer. Other risks include:
- Fair skin.
- Exposure to chemicals like radium and arsenic.
- Immunosuppression from medicines or HIV.
- Chronic wounds and burns.
- HPV.
- Genetic syndromes.
- Having many moles.
- Older age.
- History of non-melanoma skin cancer (either yourself or a family member).
Screening
The best way to screen for skin cancer is with a full skin check. Your skin may be checked during routine physicals, but it is also important to check your own skin. You will likely notice changes earlier if you do your own checks.
Moles that cause concern are those that have “ABCDE” traits.
- Asymmetry: one side of the mole is not the same as the other.
- Border Irregularity: the border (edges of the mole) should be well-defined. Blurry or uneven borders are not normal.
- Color: if the mole has many colors or if the color has changed.
- Diameter: any mole that is larger than the diameter of a pencil eraser.
- Evolution: any change in appearance, color, shape, or height over time needs to be looked at.
Signs of Non-Melanoma Skin Cancer
Any mole or skin change with “ABCDE” traits can be a sign of non-melanoma skin cancer. Basal cell carcinomas often look like a pearly or crusty patch that does not heal. They don’t often hurt and grow slowly. Squamous cell carcinomas are small, painless, raised and crusty. Both types of lesions can bleed and both are often found on areas of the body exposed to the sun.
Diagnosis of Non-Melanoma Skin Cancer
If your healthcare provider thinks you have non-melanoma skin cancer, you will have a biopsy. A dermapathologist will do a pathology report and send it to your healthcare provider. A pathology report describes all of the aspects of the skin cancer.
Staging
The TNM system is also used to describe squamous cell non-melanoma cancers. This includes:
- Size and location of the tumor.
- Whether cancer cells are found in the lymph nodes.
- Whether cancer cells are found in other areas of the body.
Staging ranges from I (one) to IV (four). Stage I is a limited disease, and stage IV is a more advanced disease.
Treatment
There are many treatments options. The type used depends on where the cancer is, the age of the patient, the extent of the disease, and if the spot has been treated before. Treatments are:
- Cryotherapy: Freezing of the lesion with liquid nitrogen.
- Excisional surgery: Surgical removal of the lesion.
- Curettage and Electrodessication: Scraping of the lesion and then using an electrical current to stop the bleeding.
- Moh’s Surgery: Removing a lesion while trying to lessen skin loss.
- Radiation therapy: Using high energy x-rays to kill cancer cells.
- Topical Treatments: Chemotherapies and medicines that are put on the skin.
- Photodynamic Therapy: Using a topical agent on the lesion and then exposing it to a wavelength of light that kills the cancer cells.
- Chemotherapy: May be used if the cancer returns or spreads to other organs.
This article is a basic introduction to non-melanoma skin cancer. You can learn more about your type of skin cancer and treatment by using the links below.